A patient who has been on long-term corticosteroid therapy has had surgery to correct an abdominal hernia. The nurse keeps in mind that which potential effect of this medication may have the most impact on the patient's recovery?

Choice A reason:This is incorrect. When mixing regular (clear) and NPH (cloudy) insulin, air should be injected into the NPH vial first, then into the regular insulin vial. This prevents contamination of the regular insulin with NPH insulin.

Choice B reason: This is incorrect because the nurse should not shake the NPH insulin vial, but rather roll it gently between the palms to mix it. Shaking can cause bubbles and affect the accuracy of the dose.

Choice C reason: This is incorrect because the nurse should draw up the regular insulin into the syringe first, then the NPH insulin. This prevents mixing of the NPH insulin with the regular insulin in the vial.

Choice D reason: This is correct. Regular insulin should always be clear. If it appears cloudy, it may be contaminated or expired and should be discarded.

Choice A reason: This is incorrect because drowsiness is not a common or serious adverse effect of alendronate. However, the client should avoid driving or operating machinery if they experience drowsiness.

Choice B reason: This is incorrect because tachycardia is not a common or serious adverse effect of alendronate. However, the client should monitor their pulse and blood pressure regularly and report any abnormal changes to the provider.

Choice C reason: This is correct because jaw pain can indicate a rare but serious condition called osteonecrosis of the jaw, which is associated with alendronate use. The client should report any jaw pain, swelling, or infection to the provider immediately and avoid dental procedures while taking alendronate.

Choice D reason: This is incorrect because dizziness is not a common or serious adverse effect of alendronate. However, the client should rise slowly from a lying or sitting position to prevent orthostatic hypotension and falls.

Choice E reason: This is correct because esophageal erosion can occur if alendronate is not taken correctly. The client should take alendronate with a full glass of water, at least 30 minutes before any food or drink, and remain upright for at least 30 minutes after taking it. The client should report any difficulty swallowing, chest pain, or heartburn to the provider.